How Was Your Day?

Please take a few minutes before the end of your shift to fill out this questionnaire to help us improve or maintain our performance at this location. All comments are confidential. Thank you for your cooperation and input.

Your Name:*

Date:*

Date

Position:*

I am a Behaviour Interventionist (BI)I am a Community Care Worker (CCW previously RCW)

Service Unit (location):*

Shift:*

Caregiver(s) you worked with:*

1. Were you greeted warmly by all staff working when you came in?

2. Were you introduced to those you may not have met yet (staff and clients)?

3. Were the staff helpful? Explained routine, shift duties, etc?

4. Were you asked throughout the shift if you required any help?

5. Did you get help/direction when/if you asked the person you were working with?

6. Did you feel included or part of the TEAM? Please give examples.

7. How would you describe overall your shift today?

8. How would you describe overall the environment of the home today? Please explain contributing factors.

Follow up notes - if required

HOW WAS YOUR DAY?